How to Apply for OIG Reinstatement
I. The OIG Reinstatement Process Most exclusions are imposed for a definite time period. The question for an excluded…
Exclusion Loophole: Medicaid Managed Care
In August, we discussed an OIG audit, which revealed that Medicaid providers who were terminated for cause were often able…
Health Care Fraud: Second Conviction Secured in Michigan Excluded Provider Scheme
In February, we reported that the Michigan Attorney General secured a racketeering and health care fraud conviction against an excluded…
Pennsylvania Judge Holds that CIA violations May Result in FCA Liability
In late July, a federal district court in Pennsylvania joined in the flurry of False Claims Act (FCA) decisions. These…
Excluded Individual Conducts Elaborate Health Care Fraud Scheme
The owner of a New Jersey ambulance company was indicted for health care fraud in mid-August of 2015. The…
Southern District of New York Provides Clarity on “Identifying” Overpayments
In early August of 2015, the Southern District of New York (SDNY) provided insight as to when the 60-day clock for…
Excluded Podiatrist Convicted of Racketeering and Health Care Fraud
I. Excluded Podiatrist Commits Health Care Fraud A Michigan podiatrist who was excluded from participation in the Federal health…
OIG Issues Advisory Opinion on Exclusions
I. Advisory Opinion on Payments for Services Provided Prior to Exclusion The Department of Health and Human Services Office of…
Must Haves for a Proper Exclusion Screening Process
At Exclusion Screening, LLCSM, we know the ins-and-outs of the exclusion screening process. In our opinion, an effective screening process…
Gary Cantrell Testimony: Failures to Report Adverse Licensing Actions Leads to Gaps in the OIG-LEIE
HHS/OIG Deputy Inspector General Gary Cantrell testified earlier this year that States are failing to report all of the adverse actions…